Interview with Brenda Carter: Clinical Breast Examinations
As of April 1st, clinical breast examinations (CBE) are no longer provided at the Southeast Regional Hub of the Ontario Breast Screening Program. There has been a gradual phasing out of CBE across the province, and Brenda Carter, Regional VP, Cancer Services explains why.
Q. Why are Clinical Breast Examinations (CBE) being discontinued?
A. Mammography is the gold standard for breast screening and remains the most effective method for detecting breast cancer. Mammograms can find early stage breast cancers before there are any signs and symptoms. The addition of clinical breast exams performed along with mammography has not been proven to reduce the death rate from breast cancer. The cancer detection rate with CBE is very low. CBE increases the number of false positives which causes unnecessary anxiety for women who then have to undergo further investigations.
Q. Are other hospitals discontinuing CBE?
A. Yes, in fact, since April 2006 all new Ontario Breast Screening Program (OBSP) screening sites have been mammography only sites. In all other provinces except Newfoundland, CBE is not offered or has been phased out.
Q. How will this affect service to patients?
A. The regional hub will continue to provide the same high quality mammography to women age 50 and over without referral from a family physician. The discontinuation of breast exams will allow us to increase our screening capacity by 20%, allowing more women access to early detection. Early detection of breast cancers means less invasive treatment and improved survival rates.
Q. Should women continue to carry out breast self-examinations?
A. We continue to recommend that women should be "Breast Aware". Just as people are encouraged to report any changes in the appearance of moles or freckles to help detect skin cancers, in a similar way, women are also advised to take note of changes to their breasts. We provide detailed breast awareness information to women at each screening so they can understand what changes to look for and to report any changes or symptoms to their health care provider.
In Ontario only 60% of eligible women are participating in breast screening. We certainly want to increase this number because the bottom line is that "Breast Screening Saves Lives". Since the screening program started, breast cancer mortality rates in Ontario, women aged 50-69 have decreased by 35%. We credit this decrease to both improved treatments and increased participation in breast screening.
Q. Who can I contact if I have more questions?
A. We have been letting our clients, family physicians and regional partners know about this change, and welcome your questions or comments. You can talk to your primary health care provider about it, or contact us at the Regional hub Ontario Breast Screening Program at 613 384-4284.
